Long-term Survival Of Dental Implants Research Articles

Analysis to evaluate novel separable dental implant stability: An experimental study in rabbits

Background/purposePeri-implantitis is a representative etiology that affects the long-term survival of dental implants. It is known that decontamination of the implant surface is essential for the successful outcome of regenerative therapy for peri-implantitis. In the present study, the stability of a novel separable dental implant (SDI) was evaluated and compared with a conventional non-separable dental implant (NDI) using biomechanical and histomorphometric analyses. Materials and methodsIn this animal study, 40 rabbits were implanted with two SDI fixtures in the left tibia and two NDI fixtures in the right tibia. The rabbits were sacrificed 3 and 6 weeks after implantation, and the implant samples were evaluated using resonance frequency analysis (RFA), micro-computed tomography (CT), removal torque testing, and histomorphometric analysis. ResultsSDI exhibited comparable or better osseointegration and implant stability to NDI. In particular, SDI showed significantly higher implant stability quotient (ISQ) values immediately and 6 weeks after implantation, while removal torque values were significantly higher at both 3 and 6 weeks. In addition, microgaps on the histomorphometric images were not observed and abnormal signs or inflammation did not occur at the connection between the top and bottom parts of the SDI. ConclusionThe novel SDI fixture demonstrated sufficient osseointegration and biomechanical stability compared with NDI in this animal study. In addition, the changeable top part of SDI indicates that it may be effective in easily treating peri-implantitis in clinical practice. Additional future studies on the stability and clinical application after loading to the fixture are necessary.

Evaluation of implants in smoking and non-smoking patients with peri-implant disease risk analysis and esthetic scores: an observational study

BackgroundThis study examined how smoking affects esthetics, peri-implant health, gingiva around the implant, and implant disease risk assessment in patients with implants.MethodsThe study included two hundred ninety-eight implants of systemically healthy patients aged between 38 and 62 who applied to the Periodontology Clinic and whose functionally prosthesis-loaded implants had been at least six months and at most five years old. Implants of patients with bruxism were not included in the study. Implants are divided into two according to the patient’s smoking. Vestibule depth around the implant, keratinized gingival thickness and width, gingival recession, bleeding on probing, pocket depth, and gingival index by a sole clinician. The pink esthetic score, peri-implant disease risk assessment, and implant health scale were also examined to measure implant esthetics and success.ResultsThere was a statistically significant difference in the implant disease risk assesment scores for the examined implants of smokers and nonsmokers (p < 0.05). People who had peri-implantitis had higher implant disease risk assesment score levels. The dental implant health scale revealed a statistically significant difference (p < 0.05) in the likelihood of implant disease. According to the dental implant health scale, dental implants were 100% successful for non-smokers. There was a significant difference in the keratinized gingiva width between smokers and nonsmokers (p < 0.05). The results of the study showed that nonsmokers had a wider keratinized gingiva.ConclusionsResearch has demonstrated that the act of smoking has the potential to jeopardize the long-term survival of dental implants and the surrounding peri-implant tissues. The results of this study indicate that it would be advisable for dentists to provide guidance to their patients on smoking cessation and to monitor any alterations in behavior closely. Furthermore, it would be advantageous for dental professionals to elucidate the impact of smoking on the susceptibility of smokers to peri-implant disease.

DENTAL IMPLANT TREATMENT IN DIABETES MELLITUS (DM) PATIENTS: REVIEW

With the development of progressive views on dental restoration and replacement, the clinical approach to seemingly hopeless clinical situations has changed radically, and those patients who would previously be considered extremely difficult are effectively provided with dental care. Diabetes mellitus (DM) is a global problem worldwide. The negative impact of the disease on bone metabolism raises some concerns about the long-term survival of dental implants in diabetic patients. Diabetes mellitus is one of the most significant somatic diseases that determine the protocol for managing dental patients and the long-term functioning of dental implantation. Protocols for the management of patients with diabetes mellitus have been developed. This article reviews the data of dental implantation in patients with diabetes mellitus. The following databases were included in a systematic search of the relevant literature: PubMed, Embase, AWMF Online, National Guidelines Clearinghouse, International Guidelines Network, and The Cochrane Library. The following search terms were used: dental implants and diabetes, diabetes and implant survival, whether diabetes is a risk factor for dental implants, peri-implantitis and diabetes. A total of 58 articles that met the inclusion criteria for this systematic review were included. The results of a systematic review showed that diabetes mellitus has an impact on implant survival rates compared with patients without diabetes.

Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review.

Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more "simplified approach" based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.

Implant position and guided placement for in-house-produced CAD/CAM restorations with titanium (Ti)-bases.

Digital dentistry has contributed to the evolution and simplification of dental implantology over the last decade. The incorporation of intraoral scanners, CBCT, 3D implant-planning software, and CAD/CAM systems makes prosthetically driven implantology a straightforward process. Such digital resources for treatment planning and execution, following evidence-based concepts, have the ability to improve the long-term esthetics and function of implant-supported restorations as well the long-term survival of dental implants. Dental implants are frequently considered as the first treatment option for replacing failing or missing teeth. However, their use in the esthetic zone remains a challenge for many clinicians. The present article provides clinical guidelines for ideal implant positioning employing computer-guided surgery and chairside CAD/CAM-fabricated provisional and definitive restorations with titanium (Ti)-bases for successful prosthetic outcomes, optimizing gingival architecture, and decreasing overall treatment duration. (Int J Comput Dent 2023;26(1):75-0; doi: 10.3290/j.ijcd.b3818287).

Evaluation of implant site preparation with piezosurgery versus conventional drills in terms of operation time, implant stability and bone density (randomized controlled clinical trial- split mouth design)

BackgroundThe preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation.MethodsTwelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months.Resultsa significant difference in terms of time of surgery (p < 0.005) and in implant stability at 4 months (p = 0.024) on the study side, while a non-statistical significance in terms of bone density was detected (p = 0.468).ConclusionThe piezoelectric implant site drilling protocol seemed to be a reliable and repeatable technique. Despite the limited sample size and lengthier operative time, the piezoelectric inserts enhanced bone quality and implant stability.Clinical trial registration Current Controlled Trials (ClinicalTrials.gov) https://clinicaltrials.gov/ct2/show/NCT05512273; the date of registration: 23/08/2022. Retrospectively registered.

12-year Single-Operator Analysis: Dental Implant Survival in Patients with Head and Neck Pathologies

Oral rehabilitation with dental implants following treatment for pathologies of the head and neck (head and neck neoplasms, odontogenic and non-odontogenic tumours of the jaw) is known to restore function and improve quality of life [1]. However, much controversy still exists over the long-term survival of dental implants in patients treated with resective surgery with or without free flap reconstruction, radiotherapy alone and/or chemotherapy.

Evaluation of Pre- and Post-loading Peri-implant Crestal Bone Levels Using Cone-beam Computed Tomography: An In Vivo Study

To evaluate the buccal, lingual, mesial, and distal crestal bone around implant using CBCT analysis having buccal crestal bone width of 1 mm after placement of implant and after 3 months of loading. Twenty-five patients between 18 and 60 years of age with adequate bone width and height were selected for this in-vivo study with single or multiple missing teeth. Surgical stent was fabricated for all of them by using self-cure acrylic resin for selection of implant according to the availability of bone, and gutta-percha was used as radio-opaque marker to locate the implant site. After proper analysis, in the first stage surgery, implants were placed. After 3 months to this, the second stage surgery was performed followed by elastomeric impression for porcelain fused to metal prosthesis fabrication. The buccal, lingual, mesial, and distal bone width and height were evaluated by using cone-beam computed tomography (CBCT). CBCT was standardized in terms of FOV (field of vision), slice thickness, and interval. After 3 months of loading, CBCT was taken to evaluate the alteration in the crestal bone around implants. Pre- and post-loading, crestal bone on four locations was measured by using CBCT software. There is significant bone loss at all the locations, buccal, lingual, mesial, and distal, at the time of placement and after 3 months of loading of implant (p <0.05). The mean difference of 0.840, 0.933, 0.840, and 0.380 at buccal, lingual, mesial, and distal locations, respectively, shows statistically significant difference in pre- and post-values of mean bone loss at buccal, lingual, mesial, and distal positions. Pre-loading bone loss was maximum in the distal surface, while post-loading bone loss was maximum in the buccal surface. From this study, it is concluded that although crestal bone loss was higher before implant placement, there was significant alteration in crestal bone even after loading of implant. It is widely accepted that the bone loss around the implant crest module is multidisciplinary in nature. Long-term preservation of the crestal bone is a paramount for successfully functioning of dental implants. Preserving crestal bone will help in dissipating the functional load. With proper treatment planning by the practitioner, this technical contribution to the crestal bone loss can be minimized and long-term survival of dental implants can be achieved.

Effect of previous implant failure on the prognosis of subsequent implants: A retrospective study.

To compare the long-term survival of dental implants placed in patients with and without a history of implant failure. Within a retrospective analysis, an experimental group was selected consisting of 59 patients with 137 implants placed after previous failure. The control group included 1,072 patients with 2,664 implants without previous failure. Kaplan-Meier curves were used to describe the group-specific long-term implant survival. Mixed-effects Cox regression models were applied to examine the effects of patient- and site-specific risk factors. To take multiple implants into account, a random intercept model was applied. During the observation period of up to 15years, 11 implants (8%) failed in the experimental group and 74 implants (2.5%) in the control group (p<.001). Five-year cumulative survival was 96.8% (95% CI 0.96-0.98) in the control group and 91.5% (95% CI 0.86-0.97) in the experimental group. The variables group assignment and simultaneous augmentation had a significant effect on survival, but this effect was lost in the random intercept model. The effect of implant location remained, whereby the risk of failure was five times lower for mandible implants, irrespective of group (p=.013; 95% CI 0.103-0.767; HR: 0.281). Long-term implant survival was lower in the experimental group than in the control group. The effect of previous failure was negligible. However, a patient-specific "clustering effect" was observed. Irrespective of previous implant failure, the risk of long-term failure is two times higher for maxillary implants than for mandibular implants.

СРАВНИТЕЛЬНАЯ ОЦЕНКА МИКРОБНОЙ КОНТАМИНАЦИИ ПРИ ПАРОДОНТИТЕ И ПЕРИИМПЛАНТИТЕ. ОБЗОР

At the present stage of the development of dentistry, dental implantation occupies a leading place in the system of complex rehabilitation of patients with defects in the dentition. The success of dental implant placement depends on many factors. Among the significant reasons influencing the positive outcome of transplantation, the state of microbiocinosis of the oral cavity of patients should be noted. The perimplant zone is a favorable habitat for anaerobes. The pathological process in the form of periodontitis, which is often the reason for the loss of teeth and the placement of implants, contributes to the progression of the inflammatory process in the periodontal tissues. This article provides an overview of the scientific litera-ture devoted to the study of microflora in inflammatory periodontal diseases. We conducted a comparative assessment of the microbiota in periodontitis and peri-implantitis, which, according to individual authors, are different ecosystems in terms of the composition of microorganisms. Alternative views on this issue were considered. Based on the analyzed scientific data, we made a conclusion about the similarities and differences in the oral microbiota in periodontitis and peri-implantitis, as well as in their combined course. We substantiated the feasibility of assessing microbial pathogens in the peri-implant area in order to develop preventive and therapeutic measures aimed at the long-term survival of dental implants.

Current concepts of surgical methods to increase mucosal thickness during dental implantation ‎

The importance of soft tissues for the maintenance of peri-implant tissue health is one of the most discussed topics in dental implantology. Numerous studies confirm that the presence of soft tissues affects the aesthetic result and the long-term survival of dental implants. It was suggested that surgical procedures aimed to increase peri-implant mucosa improve outcomes of implant treatment. This literature review aims to make an overview of methods of soft tissue management around dental implan

Implant and Peri-implant Tissue Maintenance: Protocols to Prevent Peri-implantitis

In the absence of prevention protocols, early diagnosis and predictable treatment options for peri-implant diseases, the long-term survival of dental implants may be compromised. The purpose of the present review is to outline risk factors/indicators for peri-implantitis and propose current protocols (2015–present) for their control and disease prevention. Recent evidence suggests that factors including use of proton-pump and selective serotonin-reuptake inhibitors, titanium-particle release, disruption of the implant-abutment connection, and prosthesis material/dimensions may increase peri-implantitis prevalence. Although the literature is still scarce, identifying these factors and developing appropriate maintenance protocols is imperative to prevent disease development. Peri-implantitis can be influenced by several risk factors/indicators that can be classified as patient related, clinical, and/or implant related. To facilitate the individualized patient risk profile assessment and guide clinical decisions, this review describes the impact of identified risk factors/indicators on peri-implant health and proposes preventive protocols based on the latest evidence.

Long-Term Survival of Dental Implants in Irradiated Head and Neck Cancer Patients: A Retrospective Analysis

Objective: To analyze the long-term survival of dental implants in patients previously treated with radiotherapy.

Long-Term Effects of Bone Morphogenetic Protein-2-Loaded Calcium Phosphate on Maxillary Sinus Lift Surgery for Delayed and Simultaneous Dental Implantation.

Maxillary sinus lift surgery (MSLS) is considered to be a useful treatment method for patients with atrophic alveolar bone. Choosing a suitable surgical procedure to simultaneously decrease graft absorption and obtain long-term survival of dental implants is still a challenge. In this study, 20 patients received MSLS with graft of bone morphogenetic protein 2 (BMP2)-loaded calcium phosphate. Dental implants were placed simultaneously in 10 patients receiving MSLS (1-stage group), and in 10 patients receiving dental implants with a 3 to 6 months delay (2-stage group). The effects were evaluated based on clinical and radiographic examination during a 4 to 5 years follow-up. The results showed that only 1 perforation of the maxillary sinus mucosa was observed in 1-stage group, and was patched with a collagen membrane. An average bone gain of 6.8 mm was observed, and all implants exhibited no looseness, peri-implantitis, or fracture, all of which were stable during the follow-up and exhibited nice dental function during a 4 to 5 years follow-up. The loss of peri-implant bone height was 1.12 ± 0.47 and 1.10 ± 0.39 mm, the probing depth of periodontal pocket was 1.79 ± 0.62 and 1.81 ± 0.71 mm, the sulcular bleeding index was 1.63 ± 0.47 and 1.72 ± 0.54 in 1-stage group and 2-stage group, respectively, and no significant differences existed between these 2 groups. These findings implied that BMP2-loaded calcium phosphate may be a suitable material for MSLS, especially for patients with minimal bone height. Clinicians can use the 1- or 2-stage technique based on clinical condition, patients' choice and clinicians' experience. In patients where implants cannot be stabilized for patients with minimal bone height, 2-stage surgery may be more suitable.

Multifunctions of dual Zn/Mg ion co-implanted titanium on osteogenesis, angiogenesis and bacteria inhibition for dental implants.

In order to enhance the rapid osseointegration and long-term survival of dental implants, various works on titanium surface modification have been carried out. However, only improving osteogenic activity of implants is not enough, because angiogenesis and bacteria inhibition are also very important for dental implants. In the present study, a novel dental implant material-dual Zn/Mg ion co-implanted titanium (Zn/Mg-PIII) was developed, which was found to have superior osteoinductivity, pro-angiogenic effects and inhibitory effects against oral anaerobes. Furthermore, synergistic effects of Zn/Mg ions on osteogenic differentiation of rBMSCs and the possible mechanism were discovered. In addition, rapid osseointegration and sustained biomechanical stability are greatly enhanced by Zn/Mg-PIII implants, which may have the potential application in dental implantation in the future. We believe this paper may be of particular interest to the readers.

HLA-typing analysis following allogeneic bone grafting for sinus lifting.

According to the Brazilian Association of Organ Transplants, in 2015, 19,408 bone transplants were performed in Brazil, over 90% by Dental Surgeons. The surgical technique itself has a respectable number of reports regarding its clinical efficacy, as measured by long-term survival of dental implants in grafted areas. Uncertainty remains, however, as to whether fresh frozen grafts from human bone donors remain immunologically innocuous in the body of the host. Six male with no previous medical history of note, including systemic diseases, surgery or blood transfusion were selected. These patients underwent reconstructive procedures (sinus lifting) using fresh frozen human bone from a tissue bank. All patients had venous blood samples collected prior to surgery and 6months after the procedure. Anti-HLA analysis for the detection of HLA (human leukocyte antigen) antibodies was performed using methods such as the LABScreen PRA Class I and Class II, LABScreen Single Antigen Class I and Class II, Luminex Platform. Reactive individuals to the screening tests (LABScreen PRA) were further investigated to determine the specificity of the antibodies detected (LABScreen Single Antigen) with a cutoff value of median fluorescence intensity ≥500. As a result, it was observed that two patients (33%) were positive in screening tests, one presenting with anti-HLA Class I and II sensitization and the other with anti-HLA class II. The specificity analysis showed that the patients sensitized to HLA class II presented 4 specificities, 3 of which immunologically relevant. In the second individual, 23 specificities were identified, 6 of which immunologically important for HLA class I and 4 specificities for HLA class II, 3 of these were immunologically important. All specificities detected had average fluorescence. These findings are suggestive that sinus-lifting procedures with allogeneic bone can induce immunological sensitization.

Health, Maintenance, and Recovery of Soft Tissues around Implants.

The health of peri-implant soft tissues is one of the most important aspects of osseointegration necessary for the long-term survival of dental implants. To review the process of soft tissue healing around osseointegrated implants and discuss the maintenance requirements as well as the possible short-comings of peri-implant soft tissue integration. Literature search on the process involved in osseointegration, soft tissue healing and currently available treatment modalities was performed and a brief description of each process was provided. The peri-implant interface has been shown to be less effective than natural teeth in resisting bacterial invasion because gingival fiber alignment and reduced vascular supply make it more vulnerable to subsequent peri-implant disease and future bone loss around implants. And we summarized common procedures which have been shown to be effective in preventing peri-implantitis disease progression as well as clinical techniques utilized to regenerate soft tissues with bone loss in advanced cases of peri-implantitis. Due to the difference between peri-implant interface and natural teeth, clinicians and patients should pay more attention in the maintenance and recovery of soft tissues around implants.

Biofunctionalization of microgroove titanium surfaces with an antimicrobial peptide to enhance their bactericidal activity and cytocompatibility

A firm peri-implant soft tissue seal is important for the long-term survival of dental implants, which demands the properties of antibacterial and cytocompatibility of the implant surfaces. In this study, GL13K, a cationic antimicrobial peptide, was immobilized onto microgroove surfaces which were 60μm in width and 10μm in depth, and the modified surfaces improved both the properties of antibacterial and cytocompatibility. The method of silanization was used to immobilize the antimicrobial peptide GL13K, which was confirmed by X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), atomic force microscopy (AFM), water contact angle measurement. Then the mechanical stability of the coatings was confirmed by ultrasonication. In vitro antibacterial tests confirmed bactericidal activity against Porphyromonas gingivalis without inhibiting its adhesion. In vitro cytocompatibility tests also confirmed that adhesion at later phase and proliferation of HGFs were greater (P<0.01) on the GL13K-modified microgroove surfaces than on the non-treated microgroove surfaces, and both of them were greater than on the smooth surfaces. The phenomenon of the contact guidance, which is cell growth aligned along the microgrooves, was maintained. Overall, this study developed a promising bi-functional surface that combined the physical and chemical properties to promote cytocompatibility and antibacterial activity simultaneously.

Role of implant diameter on long-term survival of dental implants placed in posterior maxilla: a systematic review.

We speculated that the long-term survival of narrow or conventional diameter (<5 mm) implants is higher than that of wide-diameter implants (≥ 5 mm) when placed in posterior atrophic maxillae. The aim of this paper was to systematically review indexed literature regarding the influence of implant diameter on long-term survival of dental implants placed in posterior maxilla. The addressed focused question was "Does implant diameter influence long-term survival of dental implants placed in posterior maxilla?" Databases were searched from 1986 till June 2014 using the following MeSH terms: "dental implants," "dental implant-abutment design," "maxilla," and "survival." Review articles, case reports, letters to the editor, unpublished data, and studies published in languages other than English were excluded. Reference list of potentially relevant original and review studies was hand-searched. The initial search yielded 51 studies. Scrutiny of the titles and abstracts reduced the number of clinical studies included in the present review to 19. Mean age of the patients ranged between 37 and 60 years. Cylindrical and tapered implants were used in 12 and 3 studies, respectively. In all studies, threaded, rough-surfaced dental implants with diameters ranging between 3.0 and 5.5 mm were used. In all studies, follow-up periods and cumulative survival rates ranged between 5 and 15 years and 80.5 and 100 %, respectively. The role of implant diameter on long-term survival of dental implants placed in posterior maxilla is secondary. A well-designed surgical protocol, achievement of sufficient primary stability at the time of implant placement, and pre- and postsurgical oral hygiene maintenance visits are critical factors that influence the long-term survival of dental implants placed in posterior atrophic maxilla.

History of periodontitis as a risk factor for long-term survival of dental implants: a meta-analysis.

The authors conducted a meta-analysis to determine the effect of a history of periodontitis on the long-term survival of dental implants. An electronic search of PubMed and a supplemental manual search were conducted. Studies published in English through March 2013 were included in the meta-analysis. Survival rates, success rates, periodontal status, types of periodontitis, most recent follow-up time, and other information were extracted and analyzed. Thirteen studies involving 2,011 patients and 6,802 implants were included in the meta-analysis. The results revealed that a history of periodontitis, especially aggressive periodontitis, is associated with significantly higher risks of long-term implant failure versus a healthy periodontium (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.02 to 1.04). Based on the limited number of included articles, a subgroup analysis showed that a history of periodontitis had no statistically significant effect on implant survival up to 100 months of follow-up (RR = 1.03, 95% CI = 0.99 to 1.06); however, it did significantly affect implant survival within a period of 101 to 200 months (RR = 1.03, 95% CI = 1.02 to 1.04). Some implant systems also significantly influenced the correlation between a history of periodontitis and implant survival. Within the limitations of this meta-analysis, a history of periodontitis is estimated to be a statistical risk factor for the long-term survival of dental implants. This negative effect would be most evident in patients with aggressive periodontitis, severe periodontitis, or after a longer follow-up.